Clinical, Radiological, and Surgical Risk Factors for Endoscopic Anastomotic Recurrence Following Surgery in Crohn's Disease.

This study investigated the radiological, clinical, and surgical factors linked to the risk of endoscopic recurrence following ileocolic resection for Crohn's disease. We conducted a retrospective analysis of data from all patients who underwent primary ileocecal resection for Crohn's disease in a single colorectal unit between 2004 and 2020. We analyzed the potential risk factors subdivided by the clinical, radiological, and surgical factors associated with morphological recurrence, as detected by endoscopy within 2 years after surgery.

Effectiveness of autologous emulsified stromal vascular fraction tissue injection for the treatment of complex perianal fistulas in inflammatory bowel diseases patients: a pilot study.

Complex fistulizing perianal disease is a disabling manifestation of inflammatory bowel disease (IBD), seriously compromising patients 'quality of life'. The success rate of available treatments is quite low, and nearly half of the patients will develop chronically active fistulas or experience fistula recurrence. Mesenchymal stem cell therapy has shown interesting results, but the complexity and the cost of production limit its widespread use.

Crohn's Disease: Radiological Answers to Clinical Questions and Review of the Literature.

Crohn's disease (CD) is a chronic, progressive inflammatory condition, involving primarily the bowel, characterized by a typical remitting-relapsing pattern. Despite endoscopy representing the reference standard for the diagnosis and assessment of disease activity, radiological imaging has a key role, providing information about mural and extra-visceral involvement. Computed Tomography and Magnetic Resonance Imaging are the most frequently used radiological techniques in clinical practice for both the diagnosis and staging of CD involving the small bowel in non-urgent settings.

Magnetic resonance imaging for assessment of rectal cancer nodes after chemoradiotherapy: A single center experience.

Background: Accurate nodal restaging is becoming clinically more important in patients with locally advanced rectal cancer (LARC) with the emergence of organ-preserving treatment after a good response to neoadjuvant chemoradiotherapy (nCRT).

Purpose: To evaluate the accuracy of MRI in identifying negative N status (ypN0 patients) in LARC after nCRT.

Material And Methods: 191 patients with LARC underwent MRI before and 6-8 weeks after nCRT and subsequent total mesorectal excision.

Imaging of Strictures in Crohn's Disease.

Crohn's disease (CD) is a chronic inflammation of the digestive tract, and it frequently affects young patients. It can involve any intestinal segment, even though it frequently affects the distal ileum. Up to 80% of patients with CD present with inflammatory behavior, and 5% to 28% develop stricturing disease.

Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography, Part II: The Reliable Disclosure of Crohn's Disease and Non-Inflammatory Small Bowel Disorder Plot through MRI Findings.

MRE has become a standard imaging test for evaluating patients with small bowel pathology, but a rigorous methodology for describing and interpreting the pathological findings is mandatory. Strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, strictures, and mesentery fat hypertrophy are all indicators of small bowel damage in inflammatory and non-inflammatory small bowel disease, and they are all commonly and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel.

Small Bowel Imaging from Stepchild of Roentgenology to MR Enterography: Part I: Guidance in Performing and Observing Normal and Abnormal Imaging Findings.

MRE has become a standard imaging test for evaluating patients with small bowel pathology, but the indications, interpretation of imaging findings, methodology, and appropriate use must be standardized and widely known. Several signs of small bowel damage in inflammatory and non-inflammatory small bowel pathology include strictures, abscess, inflammatory activity, sinus tract, wall edema, fistula, mucosal lesions, and mesentery fat hypertrophy, all of which are widely and accurately explained by MRE. MRE is a non-invasive modality that accurately assesses the intra-luminal, parietal, and extra-luminal small bowel.

How the Radiologist Must Reason for a Correct Diagnosis in Patients With Small Bowel Mural Thickening Studied by CT or MRI: A Pictorial Review.

Conditions that lead to small bowel mural thickening fall into a broad spectrum of diseases, including inflammatory, infectious, vascular or neoplastic. Computed tomography (CT) and Magnetic Resonance Imaging (MRI), especially CT-enterography and MR-enterography, permit evaluation of both entire small bowel and extraluminal structures. In CT/MR-enterography, the main prerequisite for the correct evaluation of small bowel is to obtain optimal intestinal distension.

Length of the healthy and pathological small intestine in patients with Crohn's disease: calculations using computed tomography and magnetic resonance enterography.

Many patients with Crohn's disease (CD) require surgical intervention during their lifetime. A correct preoperative assessment of the intestinal length is necessary to predict and quickly treat postoperative nutritional disorders. The aim of this paper is to explain the method used in our hospital to measure intestinal length in patients with CD and its usefulness for making the correct therapeutic decision.

Radiomics could predict surgery at 10 years in Crohn's disease.

Background: Predicting clinical outcomes represents a major challenge in Crohn's disease (CD). Radiomics provides a method to extract quantitative features from medical images and may successfully predict clinical course.

Aims: The aim of this pilot study is to evaluate the use of radiomics to predict 10-year surgery for CD patients.

Usefulness of FDG-PET/CT and MRI in an immunocompetent patient with fever of unknown origin and following diagnosis of skeletal tuberculosis: A case report.

Introduction: Fever of unknown origin (FUO) is one of the most difficult diagnostic dilemmas in current medicine. The main causes of FUO in developed countries are non-infectious inflammatory diseases, while infections are predominant in developing countries. Among infections, Mycobacterium Tuberculosis (TB) is the most frequent cause and it can involve multiple tissues and organs.

CT and MRI Evaluations in Crohn's Complications: A Guide for the Radiologist.

Inflammatory bowel diseases (IBD) are a group of chronic inflammatory intestinal conditions with unknown etiology. Crohn's disease (CD) and ulcerative colitis (UC) are the two main types of IBD and they have some interchangeable and some different clinical and pathological characteristics. When diagnosis is performed for the first time, the majority of CD patients have a predominant inflammatory condition.

Challenges in Crohn's Disease Management after Gastrointestinal Cancer Diagnosis.

Crohn's disease (CD) is a chronic inflammatory bowel disease with a progressive course, potentially affecting the entire gastrointestinal tract from mouth to anus. Several studies have shown an increased risk of both intestinal and extra-intestinal cancer in patients with CD, due to long-standing transmural inflammation and damage accumulation. The similarity of symptoms among CD, its related complications and the de novo onset of gastrointestinal cancer raises difficulties in the differential diagnosis.

CT of the acute colonic diverticulitis: a pictorial essay.

Acute colonic diverticulitis (ACD) is an acute episode of severe and prolonged lower abdominal pain due to diverticular inflammation, usually associated with change in bowel movements, fever, and leukocytosis. Worldwide, computed tomography (CT) of the abdomen and pelvis with intravenous contrast is accepted as the best imaging method for evaluating the diverticular inflammation, serving the following functions: confirming the presence of ACD; evaluation of the disease severity and degree; therapy planning guide in presence of complications (such as abscess or intestinal perforation); diagnosis of other diseases that may simulate diverticular inflammation. In the literature, we found values of CT sensitivity for diverticular inflammation from 79% to 99%; CT is useful in differentiating other diseases, which may cause abdominal pain, when diverticular inflammation is not the cause, such as neoplasm, inflammatory bowel disease, appendix inflammations, epiploic appendix inflammation and colon ischemia.

A modern multidisciplinary approach to the treatment of enterocutaneous fistulas in Crohn's disease patients.

Introduction: Enterocutaneous fistulas (ECFs) is a manifestation of penetrating Crohn's disease (CD) that is challenging to treat and has considerable morbidity and mortality rates.

Areas Covered: This review aims to explore the practical and updated principles for the optimal treatment of ECFs in CD patients.

Expert Opinion: Optimal ECF management requires a multidisciplinary approach.

A review of Magnetic Resonance Enterography classification and quantitative evaluation of active disease in patients with Crohn's disease.

Crohn's disease (CD) is a chronic inflammation of the gastro-intestinal system in which episodes of clinical worsening alternate with episodes of clinical regression. Monitoring of disease is mandatory to evaluate the efficacy of therapy and it is usually performed using a combination of clinical symptoms, laboratory tests, endoscopy and radiological exams, such as MR enterography or CT enterography. MR enterography should be preferred to CT enterography because of the absence of ionizing radiation, a very high soft tissue contrast, and a lower incidence of adverse events.

Crohn's disease activity before and after medical therapy evaluated by MaRIA score and others parameters in MR Enterography.

Aim: Aim of this retrospective study is to evaluate the response to therapy in Crohn's disease (CD) patients studied by MR Enterography (MRE) in comparison with Harvey Bradshaw Index (HBI).

Methods: One hundred and sixty patients with histological proved CD have undergone MRE in the last years. Forty-six patients who repeated MRE after medical therapy within six months were selected for the study.

A Case of Primary Localized Small Bowel Amyloidosis Studied by 18F-Choline and Contrast-Enhanced 18F-FDG PET/CT.

Amyloidosis is a rare hereditary or acquired protein deposition disorder with different etiologies, characterized by pathological protein deposition essentially in nearly any organs or tissues. There are 2 major forms: primary and secondary amyloidosis. Moreover, it is possible to have systemic or localized disease.

Muscle Recurrence of a Primarily Nodal Follicular Lymphoma Studied by Contrast-Enhanced 18F-FDG PET/CT.

We report the case of a 52-year-old woman with follicular lymphoma localized in the left inguinal region without any extranodal involvement and achieving a complete response after radiotherapy. After a 3-year disease-free interval, muscular recurrence at the left arm was shown by contrast-enhanced F-FDG PET/CT. Contrast-enhanced F-FDG PET/CT performed after immunochemotherapy documented complete disease remission.

Assessment of Crohn's Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations.

Unlabelled: Crohn's disease (CD) is a chronic inflammatory condition characterized by continuous mucosal damage and ongoing wound healing of the intestines. The fibrinolytic system is involved in early parts of the wound healing process. Fibrin is a key mediator of primary blood clot formation and is formed by cross-linking of fibrinogen.

Richter Syndrome Presenting With Colon Localization.

A 75-year-old man, who had been diagnosed with small lymphocytic lymphoma with cervical localization, underwent F-FDG PET/CT with iodinated contrast medium due to the appearance of cervical swelling suspected of illness relapse. PET/CT revealed intense F-FDG uptake in multiple cervical and subdiaphragmatic lymph nodes and in the left parotid. Moreover, diffuse uptake and wall thickening of the colon were evident; endoscopy with biopsy revealed a diffuse large B-cell lymphoma.

Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn's Disease.

Aim: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn's disease (CD).

Methods: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively.

Enterography CT without and with water enema in patients with Crohn's disease: Results from a comparative observational study in comparison with endoscopy.

Objectives: CT is nowadays an examination routinely performed in Crohn's disease (CD) patients. However, there are several ways to assess gastro-intestinal tract, in particular colonic segments. Aim of this study is to compare enterography-CT (E-CT), performed after oral administration of polyethylene-glycol solution (PEG-CT) versus enterography-CT performed also with water enema via rectum (ECT-WE) in patients with CD.

Comparison between clinical and radiological evaluation before and after medical therapy in patients with Crohn's disease: new prospective roles of CT enterography.

Purpose: In recent years, CT enterography (CTE) has emerged as an important methodology to study patients with Crohn's disease (CD). The aim of this study was to evaluate the correlation between clinical response to therapy and CTE findings in CD patients.

Materials And Methods: Forty-five patients with proven CD underwent CTE before and after medical therapy.

Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn's disease: CT findings and correlation with endoscopy.

The aim of this study was to evaluate the accuracy of multidetector CT in patients with Crohn's disease (CD) relapse after ileocolic resection compared with endoscopy. Thirty-four patients were studied by endoscopy and multidetector CT, after oral administration of polyethylene glycol solution (n = 21) or after administration of methylcellulose via nasojejunal tube (n = 13). In CT examinations we evaluated the presence of mural thickening, target sign, perienteric stranding, comb sign, fibrofatty proliferation and complications.